Flashcards in Intestinal Failure Deck (17):
Define intestinal failure.
Inability to maintain adequate nutrition or fluid status via intestines.
Inability to maintain protein, electrolyte, fluid, micronutrient levels
List some reasons that might cause intestinal failure
obstruction, dysmotility, post op, congenital
Which of the 3 types of intestinal failure are acute or chronic?
1. Acute- Type 1, 2
2. Chronic - Type 3
What is Type 1 intestinal failure?
Self limiting, Short term. Either post-op or paralytic ileus.
What is Type 2 intestinal failure?
Prolonged, associated with sepsis, metabolic or surgical complications.
What is Type 3 intestinal failure?
Long term, parenteral nutrition needed
What is the management of Type 1 failure?
1. Replace fluids, Correct electrolytes
2. Parenteral nutrition- if unable to tolerate oral fluids./food
3. Acid suppression drugs
4. Allow some enteral feeding
What is parenteral feeding?
IV admission of nutrients. May be supplemental or only source of nutrition
What are the two types of access used in parenteral feeding?
1. Central- central catheters used in tunnelled subclavian vein central lines
2. Peripheral- central catheters used in peripheral veins.
What are some complications of using parenteral feeding? (5)
2. SVC thrombosis
3. Nutritional toxicity
5. Line leakage/fracture
Type 2 intestinal failure patients often develop this as a result of _
Also seen in perioperative feeding complications
Parenteral +/- enteral feeding
What are the management options in Type 3 failure? (4)
1. Home parenteral nutrition
2. Intestinal transplantation
3. Teduglutide treatment
4. Bowel lengthening
Two methods of bowel lengthening?
1. Longitudinal lengthening- splitting the bowel into before joining the longitudinal lengths together.
Increases length but reduced radius
2. Serial transverse enteroplasty- Little cuts are made in a zig zag pattern along the bowel, increasing amount of absorption
What is the choice of treatment in chronic intestinal failure?
Home parenteral nutrition
What is short bowel syndrome?
Length of small bowel insufficient to meet nutritional needs without artificial support
Has to be less than 200cm of small bowel
Normal length- 250-850
Small bowel transplantation is mostly successful. T/F?